Healthcare Provider Details

I. General information

NPI: 1831190826
Provider Name (Legal Business Name): FRANK JAMES GIANCOLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/06/2023
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 SUDLEY RD SUITE 306
MANASSAS VA
20110-4420
US

IV. Provider business mailing address

8640 SUDLEY RD SUITE 306
MANASSAS VA
20110-4420
US

V. Phone/Fax

Practice location:
  • Phone: 703-330-3939
  • Fax: 703-331-0959
Mailing address:
  • Phone: 703-330-3939
  • Fax: 703-331-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101042910
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: